"There’s a real failure to recognise how important the health status of inmates is to the public health of all of us," says Rachel Schwartz, Ph.D., a researcher at the Institute for Biosecurity at Saint Louis University School of Public Health. "Nearly 85 percent of those in jails and prisons will be released within a year. So even if we as a society don't think protecting them from disease is a priority, prisoners released into the general population pose a real threat to society."

Schwartz and fellow researchers studied research and protocols from the Centers for Disease Control, the World Health Organization and other governments to identify what plans were in place for prisons should an infectious disease break out. Many of the correctional facilities that Schwartz and colleagues studied have acknowledged they do not have an adequate plan to deal with a pandemic or similar health crisis. Schwartz says there’s reluctance among government leaders to provide prisoners with medical care, such as flu vaccines.

"The thinking is that there won’t be enough for the general public, and that they should get the shots first," she says. "We tend to think of all inmates as being violent offenders, but the average length of incarceration is only 48 hours. Many are not convicted criminals, but rather people merely accused of crimes and awaiting trial. "We know that illness among prisoners will eventually spread and cause illness in society, so we must address this now."

The solution, says Schwartz, is to spend more energy and money on preparedness. She and fellow researchers developed a plan to educate the judicial and prison systems on ways to prevent the spread of disease, from meticulous hand-washing to appropriate use of quarantine and isolation in prison and jail settings.